NPI | 1790187003 |
---|---|
Former Name | KRISTA KAY GAGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95001048) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 824700) |
Enumeration Date | 2014-09-17 |
Last Update Date | 2020-02-14 |