NPI | 1407258965 |
---|---|
Former Name | LAURA KATHRYN RODE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60806374) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5793) |
Enumeration Date | 2014-09-16 |
Last Update Date | 2020-12-02 |