| NPI | 1164929824 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OH RN.519964) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: OH LPN.114128.MEDS) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2023-02-21 |