| NPI | 1447508767 |
|---|---|
| Former Name | JILAINE ALYSE MARDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: MA RN2277122) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2012-08-16 |