| NPI | 1932616323 |
|---|---|
| Former Name | JESSICA WUNDERLICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175728) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0024175728) |
| Enumeration Date | 2018-01-07 |
| Last Update Date | 2023-09-15 |