| NPI | 1255456620 |
|---|---|
| Former Name | TRACI RENEE GORMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 16153) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 462956) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2012-06-06 |