NPI | 1851536015 |
---|---|
Former Name | JENNIFER LEIG DAMEWOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 13667) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TN APN0000013667) |
Enumeration Date | 2008-12-02 |
Last Update Date | 2022-11-23 |