NPI | 1093125965 |
---|---|
Former Name | KIRSTEN MEYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006986) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006986) |
Enumeration Date | 2014-05-01 |
Last Update Date | 2019-09-24 |