NPI | 1306251327 |
---|---|
Former Name | ROSA GRAYSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ AP5665) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ TAP5665) |
363LF0000X Nurse Practitioner Family (Licence: AZ AP5665) | |
Enumeration Date | 2014-06-27 |
Last Update Date | 2023-02-23 |