NPI | 1790207900 |
---|---|
Former Name | KARA A LACOSTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA6832) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-07-10 |
Last Update Date | 2022-01-10 |