Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD470133 | PA |
NPI | 1033571088 |
---|---|
Provider Name | Priscilla April Lao |
First Address | Philadelphia, PA 19107-5109 |
Second Address | Philadelphia, PA 19107-5109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2016 |
Last Update Date | 16/09/2020 |