NPI | 1497313902 |
---|---|
Former Name | JESSICA DOOLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05876) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11591) |
Enumeration Date | 2019-05-30 |
Last Update Date | 2022-09-18 |