| NPI | 1801558549 |
|---|---|
| Former Name | JESSANA MADELYN WESTBROOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-007960) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-007960) |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2021-12-20 |