NPI | 1295065902 |
---|---|
Former Name | JASMINE MARIE PAGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME 124530) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R71613) |
208000000X Pediatrics (Licence: AL 31535) | |
Enumeration Date | 2009-12-30 |
Last Update Date | 2016-08-12 |