NPI | 1316103542 |
---|---|
Former Name | JENNIFER LAONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 003868) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 061785) |
Enumeration Date | 2008-08-07 |
Last Update Date | 2013-02-21 |