NPI | 1578088688 |
---|---|
Former Name | ERIKA LEESE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059004) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059004) |
Enumeration Date | 2017-08-09 |
Last Update Date | 2024-12-12 |