| NPI | 1962898726 |
|---|---|
| Former Name | LAURA FRESE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006626) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005876) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2021-09-22 |