| NPI | 1699335059 |
|---|---|
| Former Name | JESSICA WOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2023-06-06 |