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Individual
MRS. KATHLEEN KAPOLKA SANON
Active
Individual
MRS. KATHLEEN KAPOLKA SANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAAA
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
006785
GA
367H00000X
Anesthesiologist Assistant
2011032949
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134569A
—
GA
Enumeration date
10/01/2011
Last updated
04/22/2020
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