NPI | 1255804613 |
---|---|
Former Name | KIMBERLY SOMERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008722A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.019967) |
Enumeration Date | 2019-01-09 |
Last Update Date | 2023-01-12 |