| NPI | 1073990149 |
|---|---|
| Former Name | JENNA ROSE MOLLISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 56104) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 56104) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2018-09-12 |