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Individual
LAURA WAIALAE
Active
Individual
LAURA WAIALAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2199
WV
363AM0700X
Medical Physician Assistant
—
NULL
363AS0400X
Surgical Physician Assistant
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0313358
—
OH
Enumeration date
07/12/2018
Last updated
06/03/2020
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