NPI | 1205366309 |
---|---|
Former Name | KAYLA A CHECKOVICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07267) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-07267) |
Enumeration Date | 2017-06-13 |
Last Update Date | 2022-03-12 |