| NPI | 1962046961 |
|---|---|
| Former Name | JESSICA LEE CORWIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2019040759) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: MO 2014036569) |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2021-11-05 |