NPI | 1982011698 |
---|---|
Former Name | KRISTEN ELIZABETH KANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00766) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3642) |
363A00000X Physician Assistant (Licence: MA PA6126) | |
363A00000X Physician Assistant (Licence: WI 3642-23) | |
Enumeration Date | 2014-07-14 |
Last Update Date | 2022-08-01 |