NPI | 1184070856 |
---|---|
Former Name | CARA CHAMPION |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRNCNP19212) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.410582) |
363LF0000X Nurse Practitioner, Family (Licence: OH COA.19212-NP) | |
Enumeration Date | 2016-05-11 |
Last Update Date | 2016-08-25 |