| NPI | 1922194414 |
|---|---|
| Former Name | LENORE RUTRH MANTIFEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH NP02818) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OH COA110972) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2015-07-17 |