| NPI | 1205239803 |
|---|---|
| Former Name | AMBER LEE KUKLINSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD 652) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 4479) |
| Enumeration Date | 2014-09-27 |
| Last Update Date | 2022-11-22 |