| NPI | 1720407059 |
|---|---|
| Former Name | LAURA ANN MAHONEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301105817) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5315066225) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-04-14 |