Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125066428 | IL |
N | 111NI0900X | Internist | 125066428 | IL |
Y | 207RG0100X | Gastroenterologist | 009022 | AZ |
NPI | 1023403623 |
---|---|
Provider Name | Dr. Laura Elizabeth Bach |
First Address | Tucson, AZ 85723-0001 |
Second Address | Tucson, AZ 85723-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2015 |
Last Update Date | 31/12/2021 |