| NPI | 1770509762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH COA.05175-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH RN246144) |
| 363L00000X Nurse Practitioner (Licence: KY 1092827) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2016-01-25 |