| NPI | 1679890925 |
|---|---|
| Former Name | JESSICA LYNN KOCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: IN 02004889) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2020-12-31 |