NPI | 1255507794 |
---|---|
Former Name | JENNIFER ANN WARNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX P2228) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2008-05-05 |
Last Update Date | 2022-10-28 |