| NPI | 1184129389 |
|---|---|
| Former Name | MARY ELIZABETH PRIDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178694) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R222258) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2020-09-17 |