| NPI | 1558875013 |
|---|---|
| Former Name | LAURA J TIERNAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059617) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 1143086) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2021-04-26 |