| 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 |