NPI | 1295150233 |
---|---|
Former Name | KAYLA ANN CZMOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1934) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0914) |
Enumeration Date | 2014-02-27 |
Last Update Date | 2019-03-28 |