| 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 | 2022-08-30 |