NPI | 1598169260 |
---|---|
Former Name | JENNIFER PONTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R213032) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 338918) |
Enumeration Date | 2014-10-09 |
Last Update Date | 2018-07-09 |