NPI | 1700371440 |
---|---|
Former Name | LORI K GROVE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP019002) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: PA RN561782) |
Enumeration Date | 2018-06-26 |
Last Update Date | 2024-07-12 |