| NPI | 1447549985 |
|---|---|
| Former Name | VERSAN JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME130663) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2022-07-21 |