| NPI | 1841506581 |
|---|---|
| Former Name | LORRIE A. CUSTARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: OK 0086013) |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2010-08-18 |