| NPI | 1285609149 |
|---|---|
| Former Name | PATRICIA M LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209-002885) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IL 209002885) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2016-04-29 |