NPI | 1912138280 |
---|---|
Former Name | AMELIA RAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP05936) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 2178) |
363LF0000X Nurse Practitioner, Family (Licence: LA RN073583) | |
Enumeration Date | 2009-08-04 |
Last Update Date | 2014-12-23 |