| NPI | 1487112215 |
|---|---|
| Former Name | ELIZABETH ALLISON RUTH GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5378555072) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022046158) |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2023-03-03 |