| NPI | 1124292081 |
|---|---|
| Former Name | JESSICA L LONG |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TN MD0000047550) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2022-03-23 |