NPI | 1750690137 |
---|---|
Former Name | JESSICA LYNN FAERBER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60611218) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 20986) |
Enumeration Date | 2010-10-01 |
Last Update Date | 2021-04-29 |