NPI | 1942620158 |
---|---|
Former Name | JENNIFER LALLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 060226) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-04-27 |
Last Update Date | 2022-11-07 |