| NPI | 1407245103 |
|---|---|
| Former Name | LAUREN RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05518) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3099) |
| Enumeration Date | 2015-01-18 |
| Last Update Date | 2016-12-28 |