| NPI | 1659562536 |
|---|---|
| Former Name | LARA ANNA LEGRADY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA164160) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: OR PA164160) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2021-01-13 |