| 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 | 2018-06-26 |