| 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 |