NPI | 1710211180 |
---|---|
Former Name | LEA MARIE DUNN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA21171) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001128A) |
Enumeration Date | 2009-10-01 |
Last Update Date | 2024-07-10 |