| NPI | 1366115917 | 
|---|---|
| Former Name | JESSICA M LAWO | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2021039632)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 5380697)  | 
| Enumeration Date | 2021-07-29 | 
| Last Update Date | 2022-11-12 |