| NPI | 1790939924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH NP10125) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH RN 186729) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH NP10125) | |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2023-03-14 |