| NPI | 1679028575 |
|---|---|
| Former Name | GRACE CAROTHERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN201867) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN201867) |
| Enumeration Date | 2016-08-20 |
| Last Update Date | 2019-11-07 |