| NPI | 1588352074 |
|---|---|
| Former Name | KRYSTAL GRAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0033208) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95034301) |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2025-05-02 |