NPI | 1588293500 |
---|---|
Former Name | JESSICA ELISE MCCAMISH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A194398) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A194398) |
Enumeration Date | 2020-04-02 |
Last Update Date | 2025-08-01 |