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 |