| NPI | 1043445760 |
|---|---|
| Former Name | REGINA CELESTE KISTNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 008159-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002266) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2016-03-28 |