| NPI | 1689321721 |
|---|---|
| Former Name | ERIN JACOBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WI 83104-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2024-01-08 |