| NPI | 1740610856 |
|---|---|
| Former Name | CRYSTAL LYNN WESOCKES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004955) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085004955) |
| 208200000X Plastic Surgery (Licence: IL 085004955) | |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2023-03-14 |