| NPI | 1124651328 |
|---|---|
| Former Name | KAYLEIGH POULIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9113285) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-02-16 |
| Last Update Date | 2021-04-30 |