| NPI | 1548559099 |
|---|---|
| Former Name | JARREL LYNNE TUSTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00580) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2022-06-01 |