| NPI | 1184979965 |
|---|---|
| Former Name | MAGGIE KRISTINE PANIK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: OH APRN.CNP.13501) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2022-07-21 |