NPI | 1215595475 |
---|---|
Former Name | LAUREN RODGERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 5874) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005874) |
Enumeration Date | 2019-06-03 |
Last Update Date | 2023-02-17 |