| NPI | 1669556783 |
|---|---|
| Former Name | KRISTA KAY MACDONALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085-003409) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: 085003409) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085003409) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-08-27 |