| NPI | 1871351320 |
|---|---|
| Former Name | LAURA MICHELLE ACKERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008651) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-07-30 |