NPI | 1679865364 |
---|---|
Former Name | LAUREN WRIGHTSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C04433) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0919) |
Enumeration Date | 2011-05-12 |
Last Update Date | 2020-04-20 |