NPI | 1316209703 |
---|---|
Former Name | KRISTIN ELIZABETH MANEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 015670) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015670) |
Enumeration Date | 2012-06-12 |
Last Update Date | 2022-11-08 |