| NPI | 1366995177 |
|---|---|
| Former Name | JILLIAN ROSE BALCEWICZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2296605) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2296605) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2022-07-21 |