NPI | 1891751327 |
---|---|
Former Name | JENNIFER D JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: TX M6064) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 30064) |
Enumeration Date | 2006-04-24 |
Last Update Date | 2019-06-04 |