| NPI | 1215198189 |
|---|---|
| Former Name | KRISTINE MARIE ROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036127366) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 149531) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2014-12-26 |