| NPI | 1831733252 |
|---|---|
| Former Name | KELLY ERIN GRAY |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP030197) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP023797) |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2024-08-14 |