| NPI | 1841565116 |
|---|---|
| Former Name | CARLY E JONES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q8292) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 47764) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2020-10-08 |