NPI | 1477107837 |
---|---|
Former Name | KAYLA M GREGG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007765) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60956859) |
Enumeration Date | 2019-07-24 |
Last Update Date | 2024-11-18 |