| NPI | 1376847319 |
|---|---|
| Former Name | LAURA CAROL MASON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004097) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2021-06-14 |