| NPI | 1669036224 |
|---|---|
| Former Name | JACQUELINE ELIZABETH PASULKA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036160926) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.074795) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2024-09-17 |