NPI | 1851646574 |
---|---|
Former Name | KELLY MARIE AMBROSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH COA13685) |
Additional Taxonomies | 163WN0800X Registered Nurse, Neuroscience (Licence: OH RN.318921) |
Enumeration Date | 2012-07-18 |
Last Update Date | 2017-11-14 |