NPI | 1417203340 |
---|---|
Former Name | KRISTEN S BEHRENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005006) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2012-0024) |
Enumeration Date | 2012-07-29 |
Last Update Date | 2019-12-19 |