| NPI | 1316114465 |
|---|---|
| Former Name | LYNETTE MYRA NIKKHAH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01354) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OR PA01354) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2014-04-01 |