| NPI | 1578839486 |
|---|---|
| Other Name | JENNIFER JEAN NISSLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A122827) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2022-01-10 |