| NPI | 1063891554 |
|---|---|
| Former Name | JENNA LYNN TJOSSEM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO DR.0059813) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL0005530) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2021-04-07 |