NPI | 1780098749 |
---|---|
Former Name | KRISTEN RIENSTRA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00339100) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2014-06-18 |
Last Update Date | 2021-05-14 |