| NPI | 1730627837 |
|---|---|
| Former Name | JESSICA WEGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: IL 238.000449) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-02-08 |