| NPI | 1275596652 |
|---|---|
| Former Name | JILL MARIE HAUNHORST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: CO 38688) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 38688) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2023-08-08 |