| NPI | 1477273514 |
|---|---|
| Former Name | JODIE BOLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28858) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 216958) |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2024-06-14 |