NPI | 1033370366 |
---|---|
Former Name | KRISTEN MARIE HEINBECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006803) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MI 925457) |
Enumeration Date | 2008-06-19 |
Last Update Date | 2022-07-01 |