NPI | 1316725609 |
---|---|
Former Name | JESSICA MATESSINO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17280) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-09-18 |
Last Update Date | 2024-11-25 |