NPI | 1326588369 |
---|---|
Former Name | ALYSSA K. LEANING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 032688) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 0004798) |
363AS0400X Physician Assistant, Surgical (Licence: WA PA61036650) | |
Enumeration Date | 2017-02-23 |
Last Update Date | 2024-10-07 |