NPI | 1578910659 |
---|---|
Former Name | LAURA ASHLEY HECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD466833) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT210533) |
Enumeration Date | 2016-05-19 |
Last Update Date | 2020-05-09 |