| NPI | 1063881779 |
|---|---|
| Former Name | KRYSTIN JANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C05891) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110010325) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2025-01-03 |