NPI | 1194378232 |
---|---|
Former Name | LAURA LEE THRASHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA18089) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61265719) |
363AM0700X Physician Assistant, Medical (Licence: OR PA195318) | |
Enumeration Date | 2019-07-18 |
Last Update Date | 2024-06-27 |