| NPI | 1174988455 |
|---|---|
| Former Name | KAITLYN ROSE LEGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06115) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61011073) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2020-03-30 |