| NPI | 1326081720 |
|---|---|
| Former Name | LORI A GRONQUIST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP2298) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP2298) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2015-08-10 |