| NPI | 1497575039 |
|---|---|
| Former Name | MARY ELIZABETH GRADES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 317303) |
| Additional Taxonomies | 163WG0100X Registered Nurse, Gastroenterology (Licence: AZ RN203810) |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2024-12-11 |