NPI | 1407559396 |
---|---|
Former Name | SARA GARDNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.0034355) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 471504) |
Enumeration Date | 2023-03-22 |
Last Update Date | 2024-06-19 |