| NPI | 1003251547 |
|---|---|
| Former Name | ATHENA JO BRAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 753786) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: CA 753786) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2013-05-09 |