| NPI | 1467619528 |
|---|---|
| Former Name | KRISTEN MARIE ADDIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NV 18856) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX Q3839) |
| 207N00000X Dermatology (Licence: AR E7443) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2020-07-06 |