| NPI | 1417059759 |
|---|---|
| Former Name | GINA THERESA CONSOLINO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209003946) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041294923) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: IL 209003946) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2017-01-30 |