NPI | 1053496489 |
---|---|
Former Name | MONA JILL GRAHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R865316) |
Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: MS R856316) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2014-08-17 |