| NPI | 1376798025 |
|---|---|
| Former Name | LAUREN ELIZABETH POTENTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 0006971) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00199900) |
| Enumeration Date | 2008-11-22 |
| Last Update Date | 2021-09-29 |