| 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 |