| NPI | 1427340892 |
|---|---|
| Former Name | JAZMIN LARISA OVERTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME136281) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 27347) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2018-05-11 |