| NPI | 1790203693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.026333) |
| Additional Taxonomies | 163WC1500X Registered Nurse Community Health (Licence: OH 41625) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: OH APRN.CNP.026333) | |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2023-07-12 |