| NPI | 1285953596 |
|---|---|
| Former Name | LAUREN ELIZABETH JESSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125057464) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-39199) |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2016-08-22 |