| NPI | 1275806705 |
|---|---|
| Former Name | LAURA JEANNE SHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2016009395) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209009353) |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2016-04-06 |