| NPI | 1356419428 |
|---|---|
| Former Name | JAMIE MICHELLE DRAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003066) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01246) |
| 363A00000X Physician Assistant (Licence: NM PA2023-0007) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2023-03-17 |