NPI | 1881724284 |
---|---|
Former Name | JENNIFER R BLOOM-LONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH RN-241081 NP-08754) |
Enumeration Date | 2007-03-06 |
Last Update Date | 2024-08-27 |