| NPI | 1710179247 |
|---|---|
| Former Name | JESSIE JANEL SOUTHERLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CO DR.0055897) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0055897) |
| 207L00000X Anesthesiology (Licence: CA A104975) | |
| 207L00000X Anesthesiology (Licence: NM MD2012-0427) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NM MD2012-0427) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A104975) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2025-09-29 |