| NPI | 1225495914 |
|---|---|
| Former Name | KRISTEN LEIGH WILEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA13602) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PA-644) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2020-03-30 |