| NPI | 1164608675 |
|---|---|
| Former Name | LAURA ANNE GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP21815) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 79112) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP009633) | |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2022-10-05 |