| NPI | 1841732781 |
|---|---|
| Former Name | JESSICA VEGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA11048) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363A00000X Physician Assistant | |
| 363AS0400X Physician Assistant, Surgical | |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA11048) | |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2019-09-18 |