Individual
JENNIFER R. ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19353
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
19353
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T33773
—
SC
Enumeration date
04/11/2006
Last updated
03/08/2024
Update your record
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