| NPI | 1770509408 |
|---|---|
| Former Name | KRISTINA M LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601002592) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6313) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2013-10-17 |