NPI | 1972937019 |
---|---|
Former Name | LAUREN NATALIE PETCHEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064622) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030985) |
Enumeration Date | 2013-08-26 |
Last Update Date | 2023-09-22 |