| NPI | 1457814998 |
|---|---|
| Former Name | ANDREA JERVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U0603) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2023-01-05 |