| NPI | 1104090117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA WOLF Owner 440-666-6457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: OH COA08023-NP) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |