| NPI | 1609442755 |
|---|---|
| Former Name | JESSICA KRESTINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-02527) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-05-30 |
| Last Update Date | 2022-08-25 |