| NPI | 1437402476 |
|---|---|
| Former Name | KIMBERLY ELIZABETH FULLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: OH COA.13859-NP) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2013-08-01 |