| NPI | 1073842506 |
|---|---|
| Former Name | REBECCA (BECKY) GRACE THORSON (MAIDEN NAME) |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00136500) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F304993) |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2015-12-07 |