NPI | 1528004983 |
---|---|
Former Name | LARA N KRAVITZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052351) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01167) |
363AM0700X Physician Assistant, Medical (Licence: PA MA052351) | |
363AM0700X Physician Assistant, Medical (Licence: PA OA003432) | |
Enumeration Date | 2006-06-22 |
Last Update Date | 2019-12-18 |