| NPI | 1487987574 |
|---|---|
| Former Name | JESSICA BRIE VAN BYSSUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 772556) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 772556) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2023-03-07 |