| NPI | 1316507114 |
|---|---|
| Former Name | LATASHA GRAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 116283) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016136) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2024-10-02 |