| NPI | 1588909261 |
|---|---|
| Former Name | JESSICA REDDING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: UT 11280373-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-1033) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2023-09-14 |