| NPI | 1306328588 |
|---|---|
| Former Name | TAYLOR BLAIR LEWIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 363A00000X) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3043) |
| 363AM0700X Physician Assistant, Medical (Licence: SC 3043) | |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2021-09-14 |