| NPI | 1184294100 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH LE-00036743) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0029192) | 
| Enumeration Date | 2021-06-30 | 
| Last Update Date | 2021-09-27 |