NPI | 1043503352 |
---|---|
Former Name | KATHRYN ANN JACOBSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SD 14775) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 58956) |
208000000X Pediatrics (Licence: SD 14775) | |
208000000X Pediatrics (Licence: MN 58956) | |
Enumeration Date | 2011-05-19 |
Last Update Date | 2024-03-20 |