| NPI | 1578121463 |
|---|---|
| Former Name | MARY ELIZABETH REID |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F304070-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY A517819-1) |
| 364SA2200X Clinical Nurse Specialist Adult Health (Licence: NY A517819-1) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |