| NPI | 1154844488 |
|---|---|
| Former Name | KORTNEY KRUEGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 4360-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4360-23) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2022-09-28 |