| NPI | 1730754375 |
|---|---|
| Former Name | JESSICA FORRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4060) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2025-01-08 |