NPI | 1104354653 |
---|---|
Former Name | LAUREN ANN DUGGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110535) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601008227) |
Enumeration Date | 2017-05-30 |
Last Update Date | 2019-02-26 |