| NPI | 1134476088 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.13636)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024172219)  | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.13636)  | |
| Enumeration Date | 2012-08-09 | 
| Last Update Date | 2022-09-30 |