| NPI | 1235689464 |
|---|---|
| Former Name | LAURENE N LUIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60708214) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2018-03-05 |