NPI | 1477757425 |
---|---|
Former Name | JENNIE LYNN OBRIEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 268683) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101242245) |
Enumeration Date | 2007-06-13 |
Last Update Date | 2022-07-21 |