| NPI | 1790251114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: OH APRN.CNP.023960) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.023960) |
| 363LF0000X Nurse Practitioner Family (Licence: OH 2018072145) | |
| 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.023960) | |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2025-08-14 |