| NPI | 1184291809 |
|---|---|
| Former Name | LAUREL BURTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02520) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2023-01-20 |