NPI | 1821878638 |
---|---|
Former Name | KAYLEE RAE LEBORGNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117963) |
Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: FL 9117963) |
Enumeration Date | 2023-10-02 |
Last Update Date | 2025-05-29 |