| NPI | 1720754716 |
|---|---|
| Former Name | JESSICA ROBINSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IN 10003348A) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: KY PA2900) |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2022-11-28 |