NPI | 1083663058 |
---|---|
Former Name | DELORETTA THERESA LAWRENCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 3709) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F332927) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2024-12-13 |