| NPI | 1689796617 |
|---|---|
| Former Name | JENNIFER LYNN STAFFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2009-0499) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A117740) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2023-10-19 |