NPI | 1073942165 |
---|---|
Former Name | LAURA R. REIGLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1951) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056448) |
Enumeration Date | 2013-11-08 |
Last Update Date | 2020-10-12 |