| NPI | 1831489483 |
|---|---|
| Former Name | LAURA JOY WATKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 55640) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2011-04-17 |
| Last Update Date | 2014-05-02 |