| NPI | 1558142604 |
|---|---|
| Other Name | TRISTY RETZLAFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MT MED-PAC-LIC-130649) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MT MED-PAC-LIC-130649) |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2023-11-15 |