NPI | 1720224496 |
---|---|
Former Name | LAURA GOULD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-01923) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0003931) |
Enumeration Date | 2008-12-30 |
Last Update Date | 2012-01-30 |