NPI | 1699840926 |
---|---|
Former Name | JESSICA LYNN PACHECO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 54744) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010245) |
Enumeration Date | 2006-11-21 |
Last Update Date | 2022-11-01 |