NPI | 1336670454 |
---|---|
Former Name | THERESE SPINELLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015711) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017004730) |
Enumeration Date | 2017-03-21 |
Last Update Date | 2017-03-21 |