NPI | 1134383540 |
---|---|
Former Name | JESSICA J TENNANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR0048600) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 9395A) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL2903) | |
Enumeration Date | 2008-07-15 |
Last Update Date | 2020-07-15 |