| NPI | 1760692198 |
|---|---|
| Former Name | ELISE MARIE JENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: WA MD.MD.60664422) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A116465) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-12-06 |