| NPI | 1871784777 |
|---|---|
| Former Name | REGINA JELLICORSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD45159) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 45159) |
| 208M00000X Hospitalist (Licence: TN 45159) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2018-06-12 |