| NPI | 1760884928 |
|---|---|
| Former Name | LAUREN VANDEVENTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11685) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005195) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2019-07-19 |