NPI | 1275937765 |
---|---|
Former Name | KIMBERLY MARIE SUIDA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5842) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 5842) |
Enumeration Date | 2014-10-13 |
Last Update Date | 2023-10-27 |