| NPI | 1134550254 |
|---|---|
| Former Name | KIRSTEN ASHLEIGH RYAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9107630) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107630) |
| Enumeration Date | 2013-11-30 |
| Last Update Date | 2020-06-12 |