| NPI | 1881902823 |
|---|---|
| Former Name | JESSICA NICOLE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX S7844) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD60465963) |
| 207V00000X Obstetrics & Gynecology (Licence: WA 60465963) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2024-05-13 |