| NPI | 1376860924 |
|---|---|
| Former Name | JENNA LEIGH WALTERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 38755) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD48098) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 201500648) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TN MD48098) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 201500648) | |
| Enumeration Date | 2010-04-22 |
| Last Update Date | 2023-03-31 |