| NPI | 1538695952 |
|---|---|
| Former Name | JESSICA M MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MN 69421) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 69421) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2024-09-03 |