NPI | 1013216399 |
---|---|
Former Name | LAURA COY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007801) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1791) |
363A00000X Physician Assistant (Licence: OH 50.004959RX) | |
363AM0700X Physician Assistant, Medical (Licence: KS 15-01544) | |
Enumeration Date | 2011-03-25 |
Last Update Date | 2021-08-31 |