| 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 |