| NPI | 1760938161 |
|---|---|
| Former Name | LAURA IDA LISBETH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024173863) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001232629) |
| Enumeration Date | 2016-08-27 |
| Last Update Date | 2018-04-04 |