NPI | 1194952655 |
---|---|
Former Name | JENNIFER ROEDEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301094370) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301094370) |
Enumeration Date | 2009-06-11 |
Last Update Date | 2012-08-27 |