NPI | 1629669213 |
---|---|
Former Name | ANDREA MAE DIBLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0028359) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.304614) |
Enumeration Date | 2021-01-27 |
Last Update Date | 2021-02-05 |