NPI | 1942680590 |
---|---|
Former Name | JENNA ANNE GONILLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 430910) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY 430910) |
Enumeration Date | 2015-06-08 |
Last Update Date | 2023-06-28 |