NPI | 1558442715 |
---|---|
Former Name | JESSICA M FANGMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: IN 01072885A) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.094922) |
208000000X Pediatrics (Licence: IN 01072885A) | |
2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: IN 01072885A) | |
Enumeration Date | 2006-10-17 |
Last Update Date | 2024-11-14 |