NPI | 1982916094 |
---|---|
Former Name | JESSICA ROLLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA1845) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1845) |
Enumeration Date | 2010-07-06 |
Last Update Date | 2017-09-11 |