NPI | 1073894408 |
---|---|
Former Name | LAUREN ASHLEY BAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: WI 2839) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1847) |
Enumeration Date | 2011-08-30 |
Last Update Date | 2022-07-21 |