| NPI | 1114180890 |
|---|---|
| Former Name | SARA CHRISTINE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA.10086-NP) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2012-07-19 |