NPI | 1700172434 |
---|---|
Former Name | JOANNE LAURA JESPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WY 9747A) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX P7926) |
Enumeration Date | 2011-06-21 |
Last Update Date | 2022-11-04 |