NPI | 1184197121 |
---|---|
Former Name | KIRSTEN MICHELLE WESA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08481) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-08481) |
Enumeration Date | 2019-01-02 |
Last Update Date | 2023-03-14 |