| NPI | 1992070551 |
|---|---|
| Former Name | SHAWANA GRAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NJ 26NJ00368700) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP011936) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2021-02-17 |