| NPI | 1881031706 |
|---|---|
| Former Name | JENNA LEIGH MARTENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 60599) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R9745) |
| Enumeration Date | 2013-06-01 |
| Last Update Date | 2016-06-28 |