NPI | 1952793895 |
---|---|
Former Name | JACQUELINE JEAN SPEER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MT MED-PHYS-LIC-113907) |
Additional Taxonomies | 208600000X Surgery (Licence: ME DO4080) |
208600000X Surgery (Licence: PA OS019754) | |
208600000X Surgery (Licence: TX S3751) | |
Enumeration Date | 2015-03-02 |
Last Update Date | 2025-03-03 |