NPI | 1790028405 |
---|---|
Former Name | JESSICA MARIE BLACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-13695) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: ID M-13695) |
Enumeration Date | 2013-04-01 |
Last Update Date | 2024-09-09 |