| NPI | 1730141987 |
|---|---|
| Former Name | LESLIE L STANDORF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 1933-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-79429) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2021-02-15 |