NPI | 1992944656 |
---|---|
Former Name | LAURA M GUNDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108898) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC SC1391FP) |
Enumeration Date | 2009-02-19 |
Last Update Date | 2016-02-06 |