| NPI | 1477701357 |
|---|---|
| Former Name | JESSICA LANE FLOWERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036.128711) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL OS10469) |
| 207N00000X Dermatology (Licence: CA 20A 11725) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2021-12-08 |