| NPI | 1790746972 |
|---|---|
| Former Name | JESSICA A BEACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C02458) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055651) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2016-10-15 |