NPI | 1598077398 |
---|---|
Former Name | LESLIE JEAN MALAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9261) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO PA.0004937) |
363A00000X Physician Assistant (Licence: CO PA.0004937) | |
Enumeration Date | 2010-07-08 |
Last Update Date | 2023-03-07 |