NPI | 1851568380 |
---|---|
Former Name | JESSICA M. GRIFFIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 21012) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 2458) |
Enumeration Date | 2008-05-14 |
Last Update Date | 2024-01-22 |