| NPI | 1649582040 |
|---|---|
| Former Name | JILL PATRICIA FUNNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101018687) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MI 5101018687) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2019-01-24 |