NPI | 1417932567 |
---|---|
Former Name | LAURIE EILEEN MARSHALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA 85069) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 094302) |
Enumeration Date | 2005-12-13 |
Last Update Date | 2011-09-15 |