NPI | 1881836005 |
---|---|
Former Name | JORDANA LAUREN WINN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60279199) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208000000X Pediatrics (Licence: WA ML60093774) | |
Enumeration Date | 2009-04-02 |
Last Update Date | 2012-10-08 |