NPI | 1063781037 |
---|---|
Former Name | KIMBERLEE K GROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704225670) |
Enumeration Date | 2011-12-21 |
Last Update Date | 2016-11-18 |