| NPI | 1558765214 |
|---|---|
| Former Name | KAYLA GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 1177) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00600900) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2022-11-02 |