NPI | 1811561988 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008281RX) |
Additional Taxonomies | 364SP0809X Clinical Nurse Specialist Psychiatric/Mental Health, Adult (Licence: NV PA2719) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-05-13 |
Last Update Date | 2024-07-04 |