| NPI | 1144434556 |
|---|---|
| Former Name | LAURA JOANNE DITTMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1438A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ID PTA242) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2017-01-20 |