NPI | 1033165329 |
---|---|
Former Name | JENNIFER ANNE DERR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200701929) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS011033L) |
Enumeration Date | 2006-05-26 |
Last Update Date | 2015-01-12 |