| NPI | 1245406453 |
|---|---|
| Former Name | LIZA MARIE O ORTILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2002008550) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2002008550) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2022-02-25 |