NPI | 1689178121 |
---|---|
Former Name | JASMINE LAVONNE OTKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL M171260) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036161689) |
207R00000X Internal Medicine (Licence: IL 125.072775) | |
Enumeration Date | 2018-03-20 |
Last Update Date | 2025-01-03 |