| NPI | 1154623015 |
|---|---|
| Former Name | LESLY TATIANA REYES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02211) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 15-02211) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2020-03-04 |