| NPI | 1699866566 |
|---|---|
| Former Name | JENINE M LYONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AZ 5330) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5330) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2024-08-02 |