| NPI | 1336847623 |
|---|---|
| Former Name | KIMBERLY RUTH WALLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: TX 936159) |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2023-02-16 |