NPI | 1609596246 |
---|---|
Former Name | LAURA ANNE PUYPE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16149) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX Pending) |
Enumeration Date | 2022-09-01 |
Last Update Date | 2024-05-23 |