NPI | 1073926374 |
---|---|
Former Name | JESSICA M MITTERHOLZER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: HI DOS-1707) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-06-04 |
Last Update Date | 2017-12-12 |