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 |