| NPI | 1346622594 |
|---|---|
| Former Name | LAURA RISNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY 2301) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3573) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2022-05-10 |