NPI | 1629489430 |
---|---|
Former Name | KAYLA ELIZABETH MCKINNON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5103) |
Enumeration Date | 2014-05-14 |
Last Update Date | 2017-01-11 |