NPI | 1528115656 |
---|---|
Former Name | JESSICA LYNNE PELOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 253640) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD12901) |
Enumeration Date | 2007-01-04 |
Last Update Date | 2014-02-21 |