| NPI | 1720330319 |
|---|---|
| Former Name | LAUREN MARIE SHOEMAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006508) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5601006508) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2025-01-14 |