NPI | 1083101653 |
---|---|
Former Name | JENNA STEPHENSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02006658A) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV DO3028) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-18 |
Last Update Date | 2023-07-07 |