| NPI | 1760817142 |
|---|---|
| Former Name | JESSICA VICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 04049) |
| Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: KY 04049) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2023-07-26 |