| NPI | 1407398548 |
|---|---|
| Former Name | JESSICA GREENWALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13723) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: PA MA058750) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2024-04-08 |