| NPI | 1427303585 |
|---|---|
| Other Name | JESSICA LOREN DONOFRIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005379) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2993) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2017-10-02 |