NPI | 1407259039 |
---|---|
Former Name | LISA K MCCOLLUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: OH 20141298) |
Enumeration Date | 2014-09-26 |
Last Update Date | 2014-09-26 |