NPI | 1790146256 |
---|---|
Former Name | LAUREN MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06520) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2512) |
Enumeration Date | 2016-03-11 |
Last Update Date | 2022-03-17 |