| NPI | 1962901207 |
|---|---|
| Former Name | MEGAN FARRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 9356) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.016511) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2019-08-23 |