| NPI | 1508184557 |
|---|---|
| Former Name | LAURA EASTBURN KECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101261499) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME121790) |
| 207R00000X Internal Medicine (Licence: OR 151494) | |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2021-06-01 |