| NPI | 1164614327 |
|---|---|
| Former Name | KRISTIN M OTZELBERGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 1790) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1790) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2022-05-24 |