| NPI | 1083385637 |
|---|---|
| Former Name | CAROLINE M MALLON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-027644) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28222151A) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71011547A) | |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2023-07-24 |