| NPI | 1083221535 |
|---|---|
| Former Name | JORDAN GRAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020021048) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81947-022) |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2024-11-06 |