| NPI | 1023094794 |
|---|---|
| Former Name | LAURA AMANDA HABER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00097800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA ma053350) |
| 363A00000X Physician Assistant (Licence: NY 008803) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-10-16 |