| NPI | 1508416884 |
|---|---|
| Former Name | LAUREN ISABEL SHAWGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.006986RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA060805) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2024-12-30 |