NPI | 1508150319 |
---|---|
Former Name | JENNIFER GLASS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024168682) |
Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0024168682) |
363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: VA 0024168682) | |
Enumeration Date | 2011-06-09 |
Last Update Date | 2023-10-25 |