| NPI | 1811381726 |
|---|---|
| Former Name | JESSICA MARIE WEYMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 61630) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2018-07-24 |