NPI | 1770834376 |
---|---|
Former Name | KRISTIN MARIE GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R218937) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD AC001546) |
Enumeration Date | 2012-09-24 |
Last Update Date | 2017-02-07 |