| NPI | 1124628359 |
|---|---|
| Former Name | LYDIA KATHERINE MCCLARAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61102619) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA.PA.61102619) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2024-07-26 |