| NPI | 1962894691 |
|---|---|
| Former Name | EMILY ELIZABETH JERNIGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0600X (Licence: FL 20993) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0102204576) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0102204576) | |
| 2084N0600X (Licence: VA 0102204576) | |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2024-05-22 |