| 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 |