| NPI | 1720159882 |
|---|---|
| Former Name | KIMBERLY DAWN JAQUES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 50633-020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 50633-020) |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2014-09-30 |