| NPI | 1629486139 |
|---|---|
| Former Name | LAURIE DIRCKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 202776) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: MA 202776) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-08-27 |