NPI | 1376587584 |
---|---|
Former Name | KIMBERLY CHEMACKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 001019) |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 1019) |
Enumeration Date | 2006-06-16 |
Last Update Date | 2022-02-28 |