| NPI | 1003370230 |
|---|---|
| Former Name | KIMBERLY M ATWATER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006218) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 363AS0400X Physician Assistant Surgical (Licence: MS PA00757) | |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2024-09-12 |