NPI | 1326370438 |
---|---|
Former Name | KIMBERLY BROOKE CAMPBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-003169) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03823) |
363A00000X Physician Assistant (Licence: VA 0110003169) | |
363A00000X Physician Assistant (Licence: WV 488) | |
363AM0700X Physician Assistant, Medical (Licence: VA 0110-002169) | |
Enumeration Date | 2010-02-01 |
Last Update Date | 2024-02-27 |