NPI | 1063763225 |
---|---|
Former Name | JAMIE LYNN LAIRD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA08172) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA08172) |
363A00000X Physician Assistant | |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2012-09-27 |
Last Update Date | 2025-05-13 |