NPI | 1982160891 |
---|---|
Former Name | BLAINE SARAH GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024180252) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC002615) |
Enumeration Date | 2019-02-15 |
Last Update Date | 2024-11-07 |