NPI | 1841282357 |
---|---|
Former Name | KRISTINE JOST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA00978) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10004840) |
Enumeration Date | 2005-08-19 |
Last Update Date | 2012-09-13 |