| NPI | 1760754600 |
|---|---|
| Former Name | LAURA LANGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2011027261) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: MO 2007021389) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2014-06-11 |