| NPI | 1134487630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE LANDRUM Practice Manager 513-275-5833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA12920NP) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2012-05-03 |