NPI | 1750343745 |
---|---|
Former Name | KRISTIN NICOLE BISHOP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 1898) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103493) |
Enumeration Date | 2006-04-05 |
Last Update Date | 2015-08-18 |