NPI | 1174815054 |
---|---|
Former Name | KIMBERLY P HOLLIER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105975) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9105975) |
Enumeration Date | 2011-05-10 |
Last Update Date | 2019-09-19 |