NPI | 1265881015 |
---|---|
Former Name | FAITH MARIE LEMIEUX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09656) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2016-06-11 |
Last Update Date | 2022-04-05 |