| NPI | 1194246256 |
|---|---|
| Former Name | LAURA DUTKIEWICZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME142907) |
| Additional Taxonomies | 286500000X Military Hospital |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2023-09-19 |