NPI | 1780691063 |
---|---|
Former Name | LAURA ANN NIZER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA04491) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04491) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2019-12-12 |