NPI | 1629360854 |
---|---|
Former Name | CRYSTAL LATOYA BURTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0036412) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH rn369157) |
Enumeration Date | 2011-05-05 |
Last Update Date | 2024-08-06 |