NPI | 1447206891 |
---|---|
Former Name | STACIA L JONES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 4625) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 41176) |
Enumeration Date | 2006-05-26 |
Last Update Date | 2022-03-28 |