NPI | 1952982779 |
---|---|
Former Name | JENNIFER MARSHALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0070082) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL.0008551) |
207Q00000X Family Medicine (Licence: UT 13877177-1205) | |
207QS0010X Family Medicine, Sports Medicine (Licence: UT 13877177-1205) | |
Enumeration Date | 2021-04-15 |
Last Update Date | 2025-09-26 |