| NPI | 1336600980 |
|---|---|
| Former Name | JESSICA MARIE HASSAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VT 042-0016210) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2023-08-24 |