| NPI | 1295869543 |
|---|---|
| Former Name | LAURA NELSON NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102202773) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2007-00859) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2023-03-07 |