| NPI | 1467829440 |
|---|---|
| Former Name | JESSICA PICINICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10251) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363A00000X Physician Assistant (Licence: CO PA.0008687) | |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2024-08-07 |