NPI | 1306562434 |
---|---|
Former Name | LAIKYN LOCKLEAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3164) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004278A) |
Enumeration Date | 2022-10-19 |
Last Update Date | 2024-04-11 |