| NPI | 1679610794 |
|---|---|
| Former Name | LINDSEY MARIE FEDOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MD C0004761) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052814) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2017-07-12 |