| NPI | 1619926177 |
|---|---|
| Former Name | LAURA NOEL BEVERLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 043094) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 043094) |
| 207Q00000X Family Medicine (Licence: WA MD60541847) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-10-06 |