NPI | 1407821549 |
---|---|
Former Name | TRACEY D DORSEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 786261) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164004) |
363LF0000X Nurse Practitioner, Family (Licence: FL 1161262) | |
Enumeration Date | 2006-02-22 |
Last Update Date | 2014-08-20 |