| NPI | 1497289607 |
|---|---|
| Former Name | LAUREN MICHELLE FREDERIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: SC LL41118) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2020-02548) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2021-07-08 |