NPI | 1891162020 |
---|---|
Former Name | KRISTIN MARIE JUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09975) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA09975) |
Enumeration Date | 2015-08-24 |
Last Update Date | 2025-10-09 |