| NPI | 1750517587 |
|---|---|
| Former Name | KYLEE SONDERGAARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.003275) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 001917) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2015-09-03 |