NPI | 1215125646 |
---|---|
Former Name | KRISTEN GAYLE BLANKEMEIER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60247903) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA 19336) |
Enumeration Date | 2007-10-10 |
Last Update Date | 2016-07-22 |