NPI | 1093058463 |
---|---|
Former Name | LAURA ELLEN SCHIESS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 55905) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2018-01536) |
207Q00000X Family Medicine (Licence: AZ 56179) | |
207Q00000X Family Medicine (Licence: CA A158424) | |
Enumeration Date | 2013-04-03 |
Last Update Date | 2024-03-25 |