NPI | 1598274706 |
---|---|
Former Name | JESSICA ANN GMEREK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004275) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059355) |
Enumeration Date | 2017-09-20 |
Last Update Date | 2022-05-19 |