NPI | 1619361508 |
---|---|
Former Name | JESSICA MCCLURE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0064095) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD188696) |
Enumeration Date | 2015-03-27 |
Last Update Date | 2020-10-02 |