NPI | 1235592189 |
---|---|
Former Name | JORDAN LYNNE SPIDLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: AL MD.44458) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.44458) |
Enumeration Date | 2016-03-29 |
Last Update Date | 2022-09-22 |