| NPI | 1306279104 |
|---|---|
| Former Name | KAYLA JO VETTLING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11349) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: 11349) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2019-03-14 |