NPI | 1730639451 |
---|---|
Former Name | KRISTEN ABBI CHAFFIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085006060) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2016-10-05 |
Last Update Date | 2019-06-12 |