Individual
IRIS KO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5818 S DIXIE HWY, WEST PALM BEACH, FL 33405-3608
(561) 782-5967
Mailing address
5818 S DIXIE HWY, WEST PALM BEACH, FL 33405-3608
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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