| NPI | 1154669364 |
|---|---|
| Former Name | LAURA A REYNOLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03971) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 2109) |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2023-11-13 |