| NPI | 1366773061 |
|---|---|
| Former Name | TRACIE MARIE WALSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 19440) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 19440) |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2015-06-18 |