| NPI | 1013395904 |
|---|---|
| Former Name | LAURA ELIZABETH BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60937058) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD60937058) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2024-03-11 |