| NPI | 1740673243 |
|---|---|
| Former Name | KIRSTEN ELIZABETH WETZEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058015) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003496) |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA003496) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA058015) | |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2022-10-26 |