NPI | 1336553288 |
---|---|
Former Name | JASMINE ALICIA TAYLOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: GA 104193) |
Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD464092) |
Enumeration Date | 2014-06-19 |
Last Update Date | 2025-04-22 |