| NPI | 1346801461 |
|---|---|
| Former Name | LAREN BROOKE JACOB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 320036) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2023-06-22 |