| NPI | 1184067845 |
|---|---|
| Former Name | JODY MARIE MANTERHACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.019351) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 726826) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2025-01-13 |