Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 2013-00860 | NC |
NPI | 1114951860 |
---|---|
Provider Name | Jessica-Lyn Masterson |
First Address | Charlotte, NC 28219-9305 |
Second Address | Charlotte, NC 28204-2990 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 27/09/2021 |