| NPI | 1003428111 |
|---|---|
| Former Name | KAYLA MARIE DEMUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113901) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9113901) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL PA9113901) | |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2021-06-25 |