| NPI | 1235416181 |
|---|---|
| Former Name | LAUREN MARIE FAIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 00110003666) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003666) |
| Enumeration Date | 2011-11-07 |
| Last Update Date | 2016-04-28 |