NPI | 1639457104 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.12445) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA12445NP) |
Enumeration Date | 2011-08-01 |
Last Update Date | 2023-12-18 |