| NPI | 1437696184 |
|---|---|
| Former Name | KIMBERLY MUCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: TX AP132983) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP132983) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2024-03-05 |