| NPI | 1215478805 |
|---|---|
| Former Name | JEANETTE LOVE TRAVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2023-00947) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 81610) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2023-05-22 |