Individual
HALLIE LUCILLE JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
295241
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036173850
IL
Other
Enumeration date
09/07/2022
Last updated
03/03/2025
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