NPI | 1760452601 |
---|---|
Former Name | JESSICA ANN TAYLOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2010-0142) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 50457-20) |
Enumeration Date | 2006-01-24 |
Last Update Date | 2023-10-18 |