NPI | 1023005717 |
---|---|
Former Name | JANET ANN JENKIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME120333) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WI 48806-20) |
Enumeration Date | 2005-09-29 |
Last Update Date | 2021-02-09 |