| NPI | 1073393898 |
|---|---|
| Former Name | LYNDI KAY BAGLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 10944) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 7636) |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2025-03-17 |