| NPI | 1962404772 |
|---|---|
| Former Name | LILLIAN GRACE KLUDO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 1544) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC APN1544) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2021-06-01 |