NPI | 1558636662 |
---|---|
Former Name | LISA ROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.13187-NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.13187-NP) |
Enumeration Date | 2012-03-22 |
Last Update Date | 2018-02-14 |