| NPI | 1669767083 |
|---|---|
| Former Name | JENNIFER NITTAYA BLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 50556) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2024-08-15 |