Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 9408072 | KS |
Y | 208600000X | Surgeon | 9408072 | KS |
NPI | 1003252461 |
---|---|
Provider Name | Sarah Corn |
First Address | Wichita, KS 67214-4923 |
Second Address | Wichita, KS 67214-3124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2013 |
Last Update Date | 06/07/2021 |