NPI | 1568882017 |
---|---|
Former Name | KAITLIN MARIE LAWRENCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5262) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TN 5262) |
Enumeration Date | 2014-04-23 |
Last Update Date | 2023-02-02 |