| NPI | 1306312319 |
|---|---|
| Former Name | KRISTA ANN BURES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WI 8773-33) |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |