NPI | 1275162034 |
---|---|
Former Name | JENNIFER MARVIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U7902) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-03 |
Last Update Date | 2024-03-20 |