| NPI | 1770772865 |
|---|---|
| Professional Name | LEIGH DIANE ROTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06090) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: IL 085.003735) |
| 363AS0400X Physician Assistant Surgical (Licence: MN 10374) | |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2015-12-21 |