| NPI | 1467612887 |
|---|---|
| Former Name | JENNA LYNN O'BRIEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P1120) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT012706) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2015-12-03 |