| NPI | 1336747120 |
|---|---|
| Former Name | MIKAYLA LYNN PAYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID PA-1960) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ID M-9901) |
| 363A00000X Physician Assistant (Licence: ID M-9901) | |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2023-04-24 |