| NPI | 1548898984 |
|---|---|
| Former Name | LAURA ZELLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5162) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5162-23) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2022-02-08 |