| NPI | 1730782608 |
|---|---|
| Former Name | LEANN KU'UNANI LAZARO IKEDA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61094379) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 61094379) |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2025-03-07 |