| NPI | 1093713919 |
|---|---|
| Former Name | LAURIE RAE STEWART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50001765) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601003719) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2007-07-09 |