Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 34.013946 | OH |
Y | 111NI0900X | Internist | 34.013946 | OH |
N | 207R00000X | Internist | LL37693 | SC |
N | 111NI0900X | Internist | LL37693 | SC |
NPI | 1003297383 |
---|---|
Provider Name | Laura Emily Roache |
First Address | Dublin, OH 43016-4141 |
Second Address | Delaware, OH 43015-7571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2015 |
Last Update Date | 25/01/2022 |