| NPI | 1790912475 |
|---|---|
| Former Name | KYLA R. HENKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 02005086) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 5101018368) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2022-09-16 |