NPI | 1528014057 |
---|---|
Former Name | JENNIFER ELAINE STASZKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 62980) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2005-00818) |
207R00000X Internal Medicine (Licence: PA OS014555) | |
Enumeration Date | 2006-05-26 |
Last Update Date | 2024-02-07 |