NPI | 1255701389 |
---|---|
Former Name | LAUREN ELIZABETH MATHEWS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 007764) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 35399) |
Enumeration Date | 2015-10-01 |
Last Update Date | 2024-03-06 |