| NPI | 1982099883 |
|---|---|
| Former Name | LAUREL C. DEZIECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 273616) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MA 273616) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2020-11-30 |