| NPI | 1649664392 |
|---|---|
| Former Name | KAYLA MICHELLE BADER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OK 2806) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA09642) |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2019-05-16 |