| NPI | 1891103495 |
|---|---|
| Former Name | JESSICA BONNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101267436) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2014-07-27 |
| Last Update Date | 2022-07-25 |