NPI | 1013623537 |
---|---|
Former Name | KAYLA RATCLIFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 860) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0009401) |
Enumeration Date | 2023-01-27 |
Last Update Date | 2025-05-16 |