| NPI | 1871880591 |
|---|---|
| Former Name | LAURA M. OTTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 2772-023) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2013-06-11 |