NPI | 1518306703 |
---|---|
Former Name | JANNA RAE GEWIRTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MN 58035) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 58035) |
Enumeration Date | 2013-06-20 |
Last Update Date | 2021-07-12 |