NPI | 1760717219 |
---|---|
Former Name | LAURA SHARP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00737) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00737) |
363A00000X Physician Assistant (Licence: MA PA3844) | |
363AS0400X Physician Assistant, Surgical (Licence: MA pa3844) | |
Enumeration Date | 2009-10-15 |
Last Update Date | 2020-09-30 |