NPI | 1952658544 |
---|---|
Former Name | CRISTA R CORBETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106885) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2012-08-14 |
Last Update Date | 2023-10-09 |