| NPI | 1114494119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI MOHR Authorized Official 330-546-5015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist, Gerontology |
| Enumeration Date | 2018-10-28 |
| Last Update Date | 2023-07-27 |