| NPI | 1578829982 |
|---|---|
| Former Name | KRYSTIN HARRISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 83059) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME123123) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2019-09-19 |