NPI | 1104363936 |
---|---|
Former Name | KATHLEEN RIESTENBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.019360) |
Enumeration Date | 2017-01-31 |
Last Update Date | 2025-04-24 |