| 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 |