NPI | 1134166234 |
---|---|
Former Name | KIMBERLEE I MILBERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NH 0574) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA001043) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2012-01-24 |