| NPI | 1760798722 |
|---|---|
| Former Name | LAURA KOPPES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10801) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 10801) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2022-02-17 |