| NPI | 1336104702 |
|---|---|
| Other Name | MARY LOUISE LILLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: MO 094759) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 094759) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2012-12-12 |