| NPI | 1093250334 |
|---|---|
| Former Name | LAURA ANN STORK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2016040138) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2006010898) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |