NPI | 1578813465 |
---|---|
Former Name | KRISSA JO HIPWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60310468) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60310468) |
Enumeration Date | 2012-09-18 |
Last Update Date | 2020-09-11 |