NPI | 1598743593 |
---|---|
Former Name | KRISTINA DAWN CHAFIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 00830) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-002366) |
363AS0400X Physician Assistant, Surgical (Licence: NC 0010-00891) | |
Enumeration Date | 2006-01-09 |
Last Update Date | 2017-04-11 |