| NPI | 1043874142 |
|---|---|
| Former Name | KYNLEA BRANTLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA4397) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2022-10-19 |