| NPI | 1386475028 |
|---|---|
| Former Name | THERESA M MODICA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP030358) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP030358) |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2024-09-06 |