| NPI | 1699209874 |
|---|---|
| Former Name | LAURA ELIZABETH KERGOSIEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101268910) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S1452) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2022-09-12 |