NPI | 1841535309 |
---|---|
Former Name | KRISTEN A VAHLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009530) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2023040348) |
Enumeration Date | 2012-12-10 |
Last Update Date | 2024-04-05 |