| NPI | 1043651342 |
|---|---|
| Former Name | KRISTIN MARIE VANDERLAAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005057) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA WA PA60394964) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2020-08-29 |