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 |