| NPI | 1346845708 |
|---|---|
| Former Name | KIMBERLY NICHOLE COHEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3842) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11080) |
| 363AM0700X Physician Assistant, Medical | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2022-02-21 |