| NPI | 1720215478 |
|---|---|
| Former Name | TRISHA JORGENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 356022-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R70641) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2011-09-22 |