NPI | 1518320464 |
---|---|
Former Name | JENNIFER LINDSAY BLACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD.36483) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-03-29 |
Last Update Date | 2022-03-29 |