NPI | 1023676640 |
---|---|
Former Name | ELONA GORMLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10016533) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201600281RN) |
Enumeration Date | 2019-05-29 |
Last Update Date | 2024-02-12 |