NPI | 1780924365 |
---|---|
Former Name | LAUREN NICOLE ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004189) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2013-02-19 |
Last Update Date | 2021-07-13 |