NPI | 1730255357 |
---|---|
Former Name | KRISTEN J PAK / KOZMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO205724) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101012874) |
207Q00000X Family Medicine (Licence: TX K5173) | |
Enumeration Date | 2006-11-27 |
Last Update Date | 2022-03-21 |