| NPI | 1568747822 |
|---|---|
| Former Name | JESSICA LYNN REUTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VI 106) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004185) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085004185) | |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2024-09-16 |