NPI | 1932353638 |
---|---|
Former Name | KRISTI MARIE GROVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 4317) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4317) |
Enumeration Date | 2008-11-06 |
Last Update Date | 2025-08-29 |