Individual
LAURA JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
ME124020
FL
390200000X
Student in an Organized Health Care Education/Training Program
182278
NC
Other
Enumeration date
05/25/2012
Last updated
08/10/2015
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