| NPI | 1053720359 |
|---|---|
| Former Name | LEAH M HANSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA 51680) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51680) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2019-09-10 |