NPI | 1326204892 |
---|---|
Former Name | KIMBERLY LYNETTE RICHARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q1163) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A111666) |
208000000X Pediatrics (Licence: WI 56993-20) | |
Enumeration Date | 2008-08-04 |
Last Update Date | 2021-12-09 |