| NPI | 1134383292 |
|---|---|
| Former Name | JENNIFER KAY STANLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2016-01186) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 262673) |
| 208600000X Surgery (Licence: IL 125054996) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2016-09-19 |