| NPI | 1174180855 |
|---|---|
| Former Name | LAUREN NICOLE WETHINGTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 1854) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02257) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2023-01-31 |