| NPI | 1952099962 |
|---|---|
| Former Name | MIKAYLA JENNY KONECNY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2063) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2024-06-13 |