| NPI | 1386377109 |
|---|---|
| Former Name | KRISTEN TANKOVICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.0031644) |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2022-07-08 |