| NPI | 1386012714 |
|---|---|
| Former Name | LAUREN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00515200) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA057758) |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2020-03-12 |