| NPI | 1336751809 |
|---|---|
| Former Name | JENNIFER MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.026532) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.026532) |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2021-08-06 |