NPI | 1295141166 |
---|---|
Former Name | KRISTINE MARY PARNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 003108) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003108) |
363AS0400X Physician Assistant, Surgical (Licence: CT 003108) | |
Enumeration Date | 2014-07-10 |
Last Update Date | 2015-03-03 |