NPI | 1649432204 |
---|---|
Former Name | JILL LYNN CHRISTIANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 105398) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-8471) |
Enumeration Date | 2008-06-25 |
Last Update Date | 2011-07-06 |