| NPI | 1194110973 |
|---|---|
| Former Name | JACQUELYN GAYLE HANCOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.142410) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-07-18 |