| NPI | 1104084060 |
|---|---|
| Former Name | KIMBERLY ELLEN BECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101251740) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA08282900) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2021-06-19 |