NPI | 1114559036 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R250262) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.026720) |
363LF0000X Nurse Practitioner, Family (Licence: OH 416133) | |
Enumeration Date | 2020-02-08 |
Last Update Date | 2023-08-21 |