| NPI | 1689178121 |
|---|---|
| Former Name | JASMINE LAVONNE OTKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036161689) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: IL 125.072775) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-07-11 |