| NPI | 1174071625 |
|---|---|
| Former Name | KAYLA KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00409800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00409800) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2020-06-13 |