| NPI | 1700438553 |
|---|---|
| Former Name | AUTUMN LEIGH CLEVENGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: VA 0024177840) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-07-11 |