NPI | 1871930743 |
---|---|
Former Name | CHRISTINA GAYLE JENKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME137610) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10046757) |
207Q00000X Family Medicine (Licence: SC 40145) | |
Enumeration Date | 2013-05-31 |
Last Update Date | 2023-02-24 |