NPI | 1891101267 |
---|---|
Former Name | KRISTIN ALICE MATTESON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031665) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2014-07-07 |
Last Update Date | 2024-08-09 |