| NPI | 1548676612 |
|---|---|
| Former Name | LAURA STAYROOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA005969) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 01100004662) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2022-04-06 |