| 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 |