NPI | 1780939520 |
---|---|
Former Name | LAUREN JULIE SIELSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006501) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2012-07-18 |
Last Update Date | 2024-08-01 |