| NPI | 1225059553 |
|---|---|
| Other Name | DIANE ELIZABETH JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA G77674) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G77674) |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MA 82212) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-04-10 |