| NPI | 1558636274 |
|---|---|
| Former Name | LAURA CORATHERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WV 01698) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07575) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2022-07-21 |