| NPI | 1013447408 |
|---|---|
| Former Name | JESSICA RENEE RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME146166) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116030252) |
| 207R00000X Internal Medicine (Licence: VA 0116030252) | |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2023-10-13 |