| NPI | 1841906500 |
|---|---|
| Former Name | MAKENZIE CUMMINGS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2025-10-30 |