| NPI | 1215396072 |
|---|---|
| Former Name | KELLY J LAURENT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 30231) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 30231) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2024-07-25 |