| NPI | 1164082558 |
|---|---|
| Former Name | KERA SPARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: OH 67.000352) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: MI 0028511962) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2025-08-11 |