| NPI | 1568819456 |
|---|---|
| Former Name | KARISSA ROSE WESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA060389) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: NY 019706-1) | |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2020-10-14 |