| NPI | 1871613380 |
|---|---|
| Former Name | JENNIFER JILL HEATON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME134154) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME134154) |
| 208D00000X General Practice (Licence: FL ME134154) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2019-05-07 |