| NPI | 1841547239 |
|---|---|
| Former Name | ABBE MICHELE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061783) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018655) |
| 363A00000X Physician Assistant (Licence: DE C5-0000831) | |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2022-06-07 |