NPI | 1376819433 |
---|---|
Former Name | DORIS BARBARA JACOBS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA G39969) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CO 22374) |
207QA0505X Family Medicine, Adult Medicine (Licence: MI 4301052531) | |
Enumeration Date | 2012-03-22 |
Last Update Date | 2021-04-20 |