| NPI | 1700149697 |
|---|---|
| Former Name | JESSICA LAUREN JIMENEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 842831) |
| Enumeration Date | 2012-06-17 |
| Last Update Date | 2012-06-17 |