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 |