NPI | 1316936172 |
---|---|
Former Name | ELIZABETH TRACY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA G047521) |
Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IA G047521) |
Enumeration Date | 2005-10-14 |
Last Update Date | 2008-02-22 |