NPI | 1891220208 |
---|---|
Former Name | JORDYN O'DONNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T5929) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101267100) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-23 |
Last Update Date | 2022-11-23 |