NPI | 1699866566 |
---|---|
Former Name | JENINE M LYONS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5330) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011148) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2022-11-28 |