NPI | 1346538964 |
---|---|
Former Name | KRISTINE YOUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60986007) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3235) |
363A00000X Physician Assistant (Licence: AK 135878) | |
Enumeration Date | 2011-07-17 |
Last Update Date | 2024-06-20 |