| NPI | 1881879690 |
|---|---|
| Former Name | LAUREN VAN DYKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 337034) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 004819) |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2023-02-07 |