| NPI | 1265140719 |
|---|---|
| Former Name | MCKENZIE MAE GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA 750199) |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2022-11-14 |