NPI | 1003885633 |
---|---|
Former Name | KRISTI JO FISHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 000894) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0669) |
Enumeration Date | 2006-03-16 |
Last Update Date | 2021-04-02 |