NPI | 1558817130 |
---|---|
Former Name | CHRISTINA MARIE FAUST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008493) |
Additional Taxonomies | 208800000X Urology (Licence: CA PA62231) |
363AS0400X Physician Assistant, Surgical (Licence: PA ma058603) | |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2016-09-01 |
Last Update Date | 2024-08-06 |