NPI | 1164002465 |
---|---|
Other Name | BRODY JAMESON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101282384) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-04-11 |
Last Update Date | 2024-06-27 |