NPI | 1972922870 |
---|---|
Former Name | JENNIFER BLACKMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA10160500) |
Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: PA MD461601) |
Enumeration Date | 2014-04-08 |
Last Update Date | 2018-08-20 |