| NPI | 1891806295 |
|---|---|
| Former Name | JESSICA A BERGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 5071259-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 5071259-1205) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-02-02 |