| NPI | 1750644175 |
|---|---|
| Former Name | JESSICA ANNE GONDELA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 69342) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 56716) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2018-08-07 |