Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207ND0101X | MOHS-Micrographic Surgeon | PA2121 | NV |
N | 207ND0900X | Dermatopathologist | PA2121 | NV |
NPI | 1073820536 |
---|---|
Provider Name | Miss Lauren Michelle Lee |
First Address | Stateline, NV 89449-5910 |
Second Address | Stateline, NV 89449-9804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2010 |
Last Update Date | 19/05/2020 |