NPI | 1093042541 |
---|---|
Former Name | KRISTEN ELIZABETH MUSSELMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5345) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012811) |
363A00000X Physician Assistant (Licence: IL 085004193) | |
363AS0400X Physician Assistant, Surgical (Licence: IL 085004193) | |
Enumeration Date | 2009-11-04 |
Last Update Date | 2024-10-23 |