NPI | 1669045993 |
---|---|
Former Name | KARLA DIJOHN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH APRN.CNP.0029350) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH 0029350) |
Enumeration Date | 2021-07-23 |
Last Update Date | 2024-12-09 |