NPI | 1538471883 |
---|---|
Former Name | JAIME LYN ESSIAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: MI 5101018666) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02004262A) |
207Q00000X Family Medicine (Licence: MI 510018666) | |
Enumeration Date | 2010-07-01 |
Last Update Date | 2025-01-08 |