| NPI | 1801203724 |
|---|---|
| Former Name | JENNIFER MAE JUPITZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 7685-851) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2023-04-12 |