| NPI | 1205585700 |
|---|---|
| Former Name | KIMBERLY GIBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: NY 790791) |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2024-10-17 |