NPI | 1740426790 |
---|---|
Former Name | JESSICA K NEWTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7115) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 1496) |
363AM0700X Physician Assistant, Medical (Licence: MD C0002927) | |
Enumeration Date | 2008-12-22 |
Last Update Date | 2024-11-19 |