| NPI | 1649448127 |
|---|---|
| Former Name | LAURALEE BROOKE ROENIGK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053039) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00184200) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2023-11-16 |