| NPI | 1073916045 |
|---|---|
| Former Name | KRISTIN L. FERGUSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110005573) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C05584) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2017-03-03 |