| NPI | 1871080291 |
|---|---|
| Former Name | JESSICA LYNN VIDAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U3820) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX U3820) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2023-09-17 |