NPI | 1134365950 |
---|---|
Former Name | KIMBERLY HALLGREN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 18599) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209007393) |
Enumeration Date | 2008-12-29 |
Last Update Date | 2023-04-11 |