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 |