NPI | 1093782914 |
---|---|
Former Name | KIMBERLY L COLPITTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01142) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA842) |
Enumeration Date | 2006-03-01 |
Last Update Date | 2019-10-28 |