NPI | 1164730487 |
---|---|
Former Name | KRISTIN KATHLEEN LANG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02551) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 001002551) |
Enumeration Date | 2010-09-21 |
Last Update Date | 2021-08-20 |