NPI | 1588780795 |
---|---|
Former Name | JENESS MICHELE CONNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036.119017) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301081592) |
Enumeration Date | 2007-03-21 |
Last Update Date | 2021-12-20 |