| NPI | 1457794125 |
|---|---|
| Former Name | LAUREN B SOUTHERN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04171) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-04171) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2021-08-06 |