| NPI | 1487967162 |
|---|---|
| Former Name | KRISTEN GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1228) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA001228) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2025-02-19 |