| NPI | 1356359889 |
|---|---|
| Former Name | KIM MARIE MYERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA001899L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002815) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2011-12-19 |