| NPI | 1780928812 |
|---|---|
| Former Name | JENNIFER MARIE MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 21713) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 565044) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |