NPI | 1295885911 |
---|---|
Former Name | LAURALIE GIBSON STEELE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 6765) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 18636) |
363AM0700X Physician Assistant, Medical (Licence: FL PA910557) | |
Enumeration Date | 2007-01-12 |
Last Update Date | 2014-08-12 |