NPI | 1245559376 |
---|---|
Former Name | JESSICA ANNE ENNS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD454737) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-8851) |
207R00000X Internal Medicine (Licence: IA 40587) | |
Enumeration Date | 2010-05-28 |
Last Update Date | 2015-07-14 |