NPI | 1770093833 |
---|---|
Former Name | KRISTEN DURBANIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA059341) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-10-03 |
Last Update Date | 2024-05-17 |