| NPI | 1740817808 |
|---|---|
| Former Name | LAURA CLINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 75907) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2023-08-03 |