| NPI | 1649656687 |
|---|---|
| Former Name | BONNIE LEKSRISAWAT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC pa031160) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005831) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2021-03-12 |