| NPI | 1346676186 |
|---|---|
| Former Name | KRISTINA MARIE MCCOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA170407) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60514736) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2015-01-16 |