| NPI | 1417967126 |
|---|---|
| Former Name | JESSICA RENE NEVINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME 24035) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 27083) |
| 207R00000X Internal Medicine (Licence: GA 062746) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2023-06-12 |