| NPI | 1558607507 |
|---|---|
| Former Name | OLIVIA ALEXIS KENYON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2015-0012) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107007) |
| 363A00000X Physician Assistant (Licence: WA PA60376448) | |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2016-03-30 |