| NPI | 1205120086 |
|---|---|
| Former Name | JACQUELYN MARIE FISHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2019-02466) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301104440) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2019-02466) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2024-02-12 |