| NPI | 1942474689 |
|---|---|
| Former Name | JESSICA BROOKE EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01318) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-01318) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2022-09-12 |