| NPI | 1881172526 |
|---|---|
| Former Name | KRISTIE THATCHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7220) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 7220) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2023-06-02 |