NPI | 1427361997 |
---|---|
Former Name | JESSICA C SIMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 014111) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055.0031118) |
Enumeration Date | 2010-07-26 |
Last Update Date | 2012-01-25 |