Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 35096472 | OH |
N | 2080P0210X | Pediatric Nephrologist | 35.096472 | OH |
NPI | 1205078763 |
---|---|
Provider Name | Kirsten Ann Kusumi |
First Address | Akron, OH 44308-1063 |
Second Address | Akron, OH 44308-1063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2009 |
Last Update Date | 22/04/2021 |