| NPI | 1780172114 |
|---|---|
| Former Name | JESSICA M EVERINGHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02006319A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2023-01-24 |