NPI | 1992540454 |
---|---|
Former Name | LISA MARIE DIMARCELLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP029818) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE L8-0010538) |
363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP028920) | |
Enumeration Date | 2024-06-26 |
Last Update Date | 2024-06-26 |