| NPI | 1972706182 |
|---|---|
| Former Name | JENNIFER ANN BAKA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD472382) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 241304) |
| 207Q00000X Family Medicine (Licence: NY 241304-1) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2021-06-28 |