| NPI | 1619961414 |
|---|---|
| Former Name | LAURA GAMBLE MCKENZIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC APN 2417) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC RN 33555) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 2417) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2011-09-30 |