NPI | 1457457129 |
---|---|
Former Name | JESSICA L DANIELS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10875) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2006-09-16 |
Last Update Date | 2025-01-18 |