| NPI | 1285955468 |
|---|---|
| Former Name | KIM GRAVES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111470) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 01758) |
| 363A00000X Physician Assistant (Licence: WA PA60511578) | |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60511578) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2018-10-22 |