| NPI | 1386953172 |
|---|---|
| Former Name | LEAH CAMILLE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004253) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085004253) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2023-09-19 |