NPI | 1851702716 |
---|---|
Former Name | LAUREN DANIELLE INNERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: WV 4307) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: PA OS017796) |
Enumeration Date | 2014-05-14 |
Last Update Date | 2024-07-30 |