| NPI | 1518237965 |
|---|---|
| Former Name | NICOLE MARIE ROQUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9266356) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9266356) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2021-02-16 |