| NPI | 1336532902 |
|---|---|
| Former Name | LAURA JO DICKMEYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2021-00840) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 009403) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2021-04-06 |