| NPI | 1487800314 |
|---|---|
| Former Name | CRISTIE MARIE WELLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-1457) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L002256) |
| 133V00000X Dietitian, Registered (Licence: NC 915208) | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2017-02-10 |