| 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 416133) |
| Enumeration Date | 2020-02-08 |
| Last Update Date | 2025-05-09 |