NPI | 1578053765 |
---|---|
Former Name | JESSICA V MISICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301504088) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301115012) |
Enumeration Date | 2018-05-14 |
Last Update Date | 2024-02-05 |