| NPI | 1215590138 |
|---|---|
| Former Name | KAYLEE NEWSOME |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8114) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2025-01-12 |