| NPI | 1013583673 |
|---|---|
| Former Name | LAUREN WOOTEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11316) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 1184289) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2024-01-24 |