| NPI | 1801357686 |
|---|---|
| Former Name | LAREN ELIZABETH CHISM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 33546) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.144957) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2024-09-23 |