NPI | 1689078149 |
---|---|
Former Name | LAUREN MCKELL BROWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 9159625-1206) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA1742) |
Enumeration Date | 2014-10-13 |
Last Update Date | 2021-12-07 |