NPI | 1013470194 |
---|---|
Former Name | TIFFANY MICHELLE PAOLILLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2289065) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2289065) |
Enumeration Date | 2019-04-07 |
Last Update Date | 2024-06-28 |