NPI | 1346633765 |
---|---|
Former Name | DIANA MARIE GRILLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH CNP.022110) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN185111) |
Enumeration Date | 2015-03-10 |
Last Update Date | 2018-01-12 |