| NPI | 1982898193 |
|---|---|
| Former Name | KRISTEN FUGATE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 2383) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102202069) |
| 207R00000X Internal Medicine (Licence: KY 03157) | |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2013-12-17 |