NPI | 1164523197 |
---|---|
Former Name | LESLEY HUFFMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2005004539) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2005004539) |
Enumeration Date | 2006-09-25 |
Last Update Date | 2024-08-02 |