NPI | 1831355346 |
---|---|
Former Name | JENNA C PETSCHKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IL 036-133212) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 52031) |
207K00000X Allergy & Immunology (Licence: MN 52031) | |
Enumeration Date | 2008-08-04 |
Last Update Date | 2013-11-13 |