| NPI | 1396942207 |
|---|---|
| Former Name | JESSICA LOUISE UPCHURCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 2334) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 201201499) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2013-04-11 |