| NPI | 1518275205 |
|---|---|
| Former Name | MARY ELIZABETH MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP06218) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN054121-AP06218) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2024-05-24 |