| NPI | 1740001718 |
|---|---|
| Former Name | FALLON MASHKOVICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP030976) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP030976) |
| Enumeration Date | 2024-10-22 |
| Last Update Date | 2024-12-05 |