| NPI | 1811216021 |
|---|---|
| Former Name | JENNIFER BROOKE WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101258315) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 25438) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2016-10-13 |