NPI | 1578966008 |
---|---|
Former Name | KYRENE M HAYNES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057195) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA057195) |
Enumeration Date | 2014-09-29 |
Last Update Date | 2023-05-23 |