| NPI | 1912419953 |
|---|---|
| Former Name | KRISTA CHIPMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4442) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 4442) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2023-08-21 |