| NPI | 1649429309 |
|---|---|
| Former Name | JILL CLARISSA NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-094834) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57-014600) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2012-07-23 |