Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 125-046179 | IL |
Y | 207X00000X | Orthopaedic Surgeon | A109222 | CA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 2008-00221 | NC |
NPI | 1215108709 |
---|---|
Provider Name | Kirstina Marie Olson |
First Address | San Francisco, CA 94158-2332 |
Second Address | San Francisco, CA 94158-2332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2008 |
Last Update Date | 06/04/2011 |