NPI | 1043734411 |
---|---|
Former Name | LAURA KRIS DUDLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-03323) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM CNP-03323) |
Enumeration Date | 2017-07-27 |
Last Update Date | 2021-05-24 |