NPI | 1639488141 |
---|---|
Former Name | JESSICA LYNNE DUMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105683) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105683) |
Enumeration Date | 2010-09-30 |
Last Update Date | 2017-06-05 |