NPI | 1063828184 |
---|---|
Former Name | LAUREN LORTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 73123) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125065769) |
207Q00000X Family Medicine (Licence: MO 2021034580) | |
Enumeration Date | 2014-07-09 |
Last Update Date | 2023-01-30 |