NPI | 1992047443 |
---|---|
Former Name | LYNN M LAKOMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006449) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085004597) |
363AS0400X Physician Assistant, Surgical (Licence: IL 085004597) | |
Enumeration Date | 2013-03-22 |
Last Update Date | 2022-11-23 |