NPI | 1235389693 |
---|---|
Former Name | KRISTY A GASVODA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-100540) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 100540) |
363L00000X Nurse Practitioner (Licence: MT 28985) | |
Enumeration Date | 2008-09-23 |
Last Update Date | 2024-12-04 |