| NPI | 1629120829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH NP-05316) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: OH NS-06340) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |