| NPI | 1225404460 |
|---|---|
| Former Name | KRISTENE MARIE WARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: LA PA.200869) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200869) |
| 363AM0700X Physician Assistant, Medical (Licence: LA PA.200869) | |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-12-17 |