| NPI | 1235496399 |
|---|---|
| Former Name | JESSICA MARIE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 128880) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35128880) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2020-06-05 |