Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OT019591 | PA |
NPI | 1003477407 |
---|---|
Provider Name | Dr. Mary Katherine Lasher |
First Address | Erie, PA 16544-0002 |
Second Address | Erie, PA 16502-2665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2019 |
Last Update Date | 26/06/2019 |