NPI | 1396805529 |
---|---|
Former Name | KRISTIN SUE ANDERSON-TAYLOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 6019) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601002268) |
363AM0700X Physician Assistant, Medical (Licence: NY 022313) | |
Enumeration Date | 2006-12-11 |
Last Update Date | 2018-09-13 |