NPI | 1275085888 |
---|---|
Former Name | KRISTEN J CONNORS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11345) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00472900) |
363A00000X Physician Assistant (Licence: IL 085.006070) | |
Enumeration Date | 2016-10-30 |
Last Update Date | 2023-09-25 |