| NPI | 1083957880 |
|---|---|
| Former Name | KIMBERLY MICHELLE CARLON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA0000002751) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PA-505) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2015-08-12 |