| NPI | 1932158706 |
|---|---|
| Former Name | MARY MCGILLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.010366) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024164434) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2022-07-21 |