| NPI | 1386772341 |
|---|---|
| Former Name | RENAE LEA WARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9108819) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108819) |
| 363A00000X Physician Assistant (Licence: CT 001887) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2023-04-20 |