NPI | 1659529451 |
---|---|
Former Name | JESSICA A MCCABE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9104731) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104731) |
Enumeration Date | 2008-09-04 |
Last Update Date | 2020-01-27 |