| NPI | 1609171347 |
|---|---|
| Former Name | LAURA NICOLE STEWART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60617391) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL2999) |
| 363A00000X Physician Assistant (Licence: WA PA60617391) | |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2021-09-22 |