| NPI | 1740710854 |
|---|---|
| Former Name | LAURA SWATERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MO 2017030806) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-02019) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2024-02-16 |