NPI | 1427660315 |
---|---|
Former Name | SELENA SKYE MCLEOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0036190) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 472778) |
Enumeration Date | 2020-08-20 |
Last Update Date | 2024-09-15 |