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 |