NPI | 1124049481 |
---|---|
Former Name | JUMOK ISENBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 1110) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OK 1110) |
Enumeration Date | 2006-07-22 |
Last Update Date | 2021-06-10 |