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 |