NPI | 1023492998 |
---|---|
Former Name | LAUREN ASHLEY PHILLIPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 018786) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 18786) |
Enumeration Date | 2015-07-10 |
Last Update Date | 2023-06-29 |