| NPI | 1104205921 |
|---|---|
| Former Name | LAUREL LINDA MULDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301507839) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61149321) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2024-09-09 |