| 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) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH APRN.CNP.019360) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2022-02-15 |