| NPI | 1285302661 |
|---|---|
| Former Name | JENNA MARIE LEGROS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 075934-23) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 075934-23) |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2022-10-18 |