| NPI | 1245901628 |
|---|---|
| Former Name | KINSEY LEA HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11666) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2024-01-29 |