| NPI | 1801222013 |
|---|---|
| Former Name | ALEXANDRA G BROUSSARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.14758) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2022-02-23 |