| NPI | 1760299846 | 
|---|---|
| Former Name | JESSICA GOODMAN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: TX 756983)  | 
| Enumeration Date | 2024-12-12 | 
| Last Update Date | 2024-12-12 |