| NPI | 1699354415 |
|---|---|
| Former Name | JESSICA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6555) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 6555) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2025-11-10 |