NPI | 1003336579 |
---|---|
Former Name | KRISTIN A WELTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 20904) |
363AM0700X Physician Assistant, Medical (Licence: 020904) | |
Enumeration Date | 2017-06-26 |
Last Update Date | 2023-06-29 |