| 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 |