NPI | 1588909048 |
---|---|
Former Name | KAYLA SHERCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 3525) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 3525) |
Enumeration Date | 2012-12-10 |
Last Update Date | 2019-12-27 |