NPI | 1649422619 |
---|---|
Former Name | KRISTIN MARIE WYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4402-23) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.003246) |
Enumeration Date | 2008-10-21 |
Last Update Date | 2023-03-13 |