| NPI | 1639671928 |
|---|---|
| Former Name | LEAH RAE HAAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: 1229957) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: DI60614169) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2025-08-08 |