NPI | 1972572022 |
---|---|
Former Name | CONNORS M TRACEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 254657) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704256710) |
Enumeration Date | 2006-03-14 |
Last Update Date | 2014-11-05 |