NPI | 1013566173 |
---|---|
Former Name | LAUREN CHRISTOFFERSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-09-10 |
Last Update Date | 2021-08-17 |