| NPI | 1497951511 |
|---|---|
| Former Name | TRACY KATHERINE BONO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: KS 24-35850-062) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MO 2006021076) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2007-07-08 |