NPI | 1144483470 |
---|---|
Former Name | JILLIAN KATHLEEN TETEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.095901) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KY R1557) |
Enumeration Date | 2008-07-07 |
Last Update Date | 2014-01-28 |