| NPI | 1073101630 |
|---|---|
| Former Name | LEIA RENEE TARBOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02946) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2024-09-30 |