NPI | 1821289265 |
---|---|
Former Name | LAUREN MICHELLE WALTERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05281) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21103) |
Enumeration Date | 2007-08-08 |
Last Update Date | 2024-05-06 |