NPI | 1124019286 |
---|---|
Former Name | LAURIE P MENG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IL 085-02082) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002082) |
Enumeration Date | 2005-10-28 |
Last Update Date | 2023-05-12 |