| 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, Psych/Mental Health (Licence: IA G047521) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2008-02-22 |