NPI | 1932408440 |
---|---|
Former Name | CRISTINA ANN EVANS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 8685) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22787) |
363A00000X Physician Assistant (Licence: AL PA.751) | |
Enumeration Date | 2011-03-23 |
Last Update Date | 2020-07-27 |