Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 255061 | MA |
NPI | 1083053714 |
---|---|
Provider Name | Dr. Jennifer Dineen |
First Address | Clare, 0 0 |
Second Address | Dublin, 0 4 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2013 |
Last Update Date | 16/06/2013 |