NPI | 1376854521 |
---|---|
Former Name | KRISTY LYNN NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 52475) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO # TL-2 132) |
207P00000X Emergency Medicine (Licence: WI 2439-320) | |
Enumeration Date | 2010-06-22 |
Last Update Date | 2022-12-07 |