| NPI | 1982174199 |
|---|---|
| Former Name | KRISTYN L STAAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 60199) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 201810671NP-PP) |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2019-01-22 |