NPI | 1457692683 |
---|---|
Former Name | LAURA MICHELE BOWMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102207913) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22845) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0116033137) | |
Enumeration Date | 2013-03-13 |
Last Update Date | 2023-06-01 |