| NPI | 1407297773 |
|---|---|
| Former Name | LILLY LUKOSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107291) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA107291) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2021-06-02 |