| NPI | 1376073791 |
|---|---|
| Former Name | LAESHA NICOLE BROOKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0089014) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2020-07-14 |