| NPI | 1184051401 |
|---|---|
| Former Name | LAUREL B CAPO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056352) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004934) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2020-10-01 |