| NPI | 1417415084 |
|---|---|
| Former Name | JACQUELINE MARIE MCSALLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7737-023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08914) |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 6876) | |
| Enumeration Date | 2019-03-03 |
| Last Update Date | 2025-04-15 |