NPI | 1366679094 |
---|---|
Former Name | JESSICA JOANNA MUSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61105739) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A108470) |
208000000X Pediatrics (Licence: NY 258653) | |
Enumeration Date | 2009-06-20 |
Last Update Date | 2024-05-13 |