| NPI | 1013023191 |
|---|---|
| Former Name | LAURA JEAN KEATLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD25229) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00044336) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2021-06-01 |