NPI | 1164927802 |
---|---|
Former Name | KAYLA ELIZABETH LEIBL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD483920) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-03-26 |
Last Update Date | 2024-05-15 |