| NPI | 1396844700 |
|---|---|
| Former Name | CHRISTINE M JACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 5101012398) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: SC 39079) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MO 2004023923) | |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WI 21376-875) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2021-10-20 |