| NPI | 1659642023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 13007) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.13007-NP) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2022-05-03 |