| NPI | 1205028164 |
|---|---|
| Former Name | LAURA MARIE MATHIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IN 01072756A) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: IN 01072756A) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2020-06-30 |