Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A145368 | CA |
NPI | 1174908669 |
---|---|
Provider Name | Hayley Jansson |
First Address | Davis-Monthan Afb, AZ 85707 |
Second Address | Davis-Monthan Afb, AZ 85707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2015 |
Last Update Date | 11/02/2022 |