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 | 2024-10-28 |