| NPI | 1538933254 |
|---|---|
| Former Name | MICHELLE DICIANNI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.028776) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.373021) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2024-07-02 |