NPI | 1932593738 |
---|---|
Former Name | KRISTEN PAGE MORRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110005720) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60538543) |
363A00000X Physician Assistant (Licence: GA 7909) | |
Enumeration Date | 2015-03-19 |
Last Update Date | 2020-10-15 |