NPI | 1366577132 |
---|---|
Former Name | STACY LOURIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000500) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0038026) |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26nn08027300) | |
Enumeration Date | 2007-02-22 |
Last Update Date | 2020-05-27 |