| NPI | 1790028405 |
|---|---|
| Former Name | JESSICA MARIE BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ID M-13695) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ID M-13695) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2020-11-04 |