| NPI | 1881974947 |
|---|---|
| Former Name | KRISTA K ERICSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 2828-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2828) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2014-12-08 |