NPI | 1013490911 |
---|---|
Former Name | TANYATTA GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 22205) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 22205) |
Enumeration Date | 2018-09-07 |
Last Update Date | 2024-07-17 |