| NPI | 1245734409 |
|---|---|
| Former Name | JORDAN MARIE MINISH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME168369) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2024-10-29 |