NPI | 1184905978 |
---|---|
Former Name | LEIGH DESOTO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OK 2596) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OK 1756) |
Enumeration Date | 2011-09-07 |
Last Update Date | 2022-07-21 |