| NPI | 1588864201 |
|---|---|
| Former Name | KRISTY SHANE BREUHL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME111429) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL 513630 TRN 9750) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2012-09-28 |