| NPI | 1629406434 |
|---|---|
| Former Name | LAUREN ELIZABETH POTESTATO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007610) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.003910) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2024-03-26 |