NPI | 1558777599 |
---|---|
Former Name | KAYLA JOSHINE RUMAGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.009735) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3394) |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2014-07-10 |
Last Update Date | 2025-01-21 |