| NPI | 1063946325 |
|---|---|
| Former Name | JORDAN DERCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: UT 13384855-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD048368) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2024-02-08 |