Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 5380425052 | KS |
NPI | 1104590215 |
---|---|
Provider Name | Baylee Elise Ehrhart |
First Address | Andover, KS 67002-8742 |
Second Address | Andover, KS 67002-8742 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2021 |
Last Update Date | 03/08/2021 |