| NPI | 1801138904 |
|---|---|
| Former Name | LAUREN R KETTERER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MA056089) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA 1102168) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2023-01-03 |