NPI | 1205287943 |
---|---|
Former Name | LANIK LYLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019879-01) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00399700) |
Enumeration Date | 2016-06-23 |
Last Update Date | 2022-04-15 |