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 |