| NPI | 1265652531 |
|---|---|
| Former Name | LAUREL ANN HICKOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD151664) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2021-03-29 |