| NPI | 1174174635 |
|---|---|
| Former Name | LAURA GOODALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009469A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201805230RN) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-10-08 |