| NPI | 1992233993 |
|---|---|
| Former Name | JACQUELYN DARLENE MAUK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA DO-06649) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-10942) |
| 208000000X Pediatrics (Licence: MN 66966) | |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2024-07-19 |