| NPI | 1871609693 |
|---|---|
| Former Name | PATRICIA LEE RARDIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06097) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-001309) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2018-06-01 |