| NPI | 1316175276 |
|---|---|
| Former Name | JENNA JACQUELINE WIRTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A12863) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA OP 60356123) |
| 208000000X Pediatrics (Licence: AZ 52022) | |
| 208M00000X Hospitalist (Licence: AZ 005879) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2020-07-01 |