| NPI | 1205588605 |
|---|---|
| Other Name | ILEANA AIMEE TULLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 23571) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2024-09-24 |