| NPI | 1770972325 |
|---|---|
| Former Name | LACY KORTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004201RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004201) |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2017-12-11 |