| NPI | 1225578909 |
|---|---|
| Former Name | KIMBERLY ERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002539A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2017002000) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2024-10-11 |