| NPI | 1679915136 |
|---|---|
| Former Name | JESSICA LEE CLARKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056201) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003073) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2020-04-13 |