NPI | 1619415361 |
---|---|
Former Name | PAMELA SUSAN GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9348211) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN9348211) |
Enumeration Date | 2017-02-02 |
Last Update Date | 2019-05-02 |